Social capital, co-production and the delivery of Putting People First: scoping a framework for social capital
Technical working paper
Report for Department of Health
August 2009
OPM page
Social capital, co-production and the delivery of Putting People First: scoping a framework for social capital
Contents
1. Introduction 1
2. Coproduction 3
2.1 What is it? 3
2.2 How it works 4
3. Social capital 9
3.1 What is it? 9
3.2 What use is it? 10
3.2 How does it help people improve their lives? 11
4. Not a panacea 13
4.1 Individual capital 14
4.2 The role of services 15
5. The implications for commissioning 17
5.1 The traditional model of social care commissioning 17
5.2 Emerging social care commissioning practice 19
5.3 A fully coproduced approach to commissioning 21
6. A draft social capital framework 27
6.1 Objectives 27
6.2 Design principles 27
6.3 A layered approach 28
6.4 Overview 29
6.5 Enabling processes 35
6.6 Cost – Benefit 38
6.7 Commissioning 40
References
46
OPM
Social capital, co-production and the delivery of Putting People First: scoping a framework for social capital
1. Introduction
This paper scopes the framework to be used as part of the way in which the Department of Health’s (DH) social capital project, within the context of Putting People First, captures existing learning about how to ensure best use of social capital and its further development, and stimulates further developmental initiatives. The report was produced by the Clive Miller from the Office for Public Management (OPM) with advice and commentary from DH staff (Martin Routledge, Ed Harding and Guy Robertson) and other colleagues undertaking work in this area including Steve Jones, Ritchard Brazil (Stamford Forum), John Gillespie (In Control), Helen Sanderson (HSA). The report is a working paper and does not represent government policy.
The Department of Health (DH) identifies four key and interconnected areas of focus for councils and their partners in the delivery of Putting People First (see Figure 1). One of these is social capital.
Figure 1: The four components of Putting People First
Source: ‘Putting People First, the whole story’, DH 2008
The delivery of Putting People First is not limited to personal budgets or to public services targeted at people eligible for state support. It is also about how people help themselves and each other as individuals, in groups and communities and how they make best use of the universal commercially and public funded resources available to all citizens in their area. This is vitally important because people are and want to be connected to each other, with a sense of well-being and belonging. It is important also because state resources are only a small part of what is available in communities. Sustainable local strategies to transform social care will have to involve supporting this community capacity or else people will continue to be limited to the passive role of “service user” and to the resources allocated to people in this role.
The significant role that social capital plays in enabling local people to meet their own needs and alongside redesigned services, enable the more efficient and effective co-production of outcomes, is now increasingly recognised. However, how it relates in practical terms to community self help and to more effective co-production has yet to be clarified and good practice described. The focus must be on both the impact of wider initiatives to build community strength and cohesion and making sure that people currently less likely to be linked in to community support are able to both benefit and contribute
In the context of the implementation of Putting People First (PPF) the DH has initiated a project that aims to: clarify the nature and role of social capital in both enabling people in local communities to directly help one another and in the co-production of outcomes; identify and exemplify how social capital can best be further developed and used in communities and its use supported by services; set out the case for its further development; and gather and share learning from trailblazer authorities. The project must also be undertaken firmly within the wider context of how all government policies contribute towards building stronger and more resilient communities, for example those relating to housing and employment.
Integral to the project will be the development of a framework that describes the role of social capital in everyday life and what people and service commissioners can do to build, sustain and avoid wasting it as part of strategies for the delivery of Putting People First. This paper draws on a limited number of sources that provide overviews of the nature and use of social capital to identify the focus that best meets the requirements of Putting People First. It also incorporates the advice from an advisory group.
Part 1: Conceptual understanding
2. Coproduction
All social care professionals are trained to enable people who use social care and their carers to: identify both their abilities and their needs; and support them in making best use of, and further developing, their abilities. Hence what people who use social care, their families and social networks do are recognised as being as important to enabling individuals to live full lives as are the services on which they draw. However, at an organisational level, the focus of performance management systems, and indeed the broader ‘public service ethos’ has been on how services produce outcomes. This has unwittingly led to practice which focuses mostly on needs and how these can be met by services. Services can become a substitute for enabling people to make best use of their own abilities and that of their social networks. Coproduction reasserts the role that people who use social care, their carers and their social networks play in meeting their own needs.
The emphasis on accountability in the public sector has often meant asking staff: ‘what you are doing for the cause?’ Translated into practice, this means: what are public services doing to produce outcomes? This is fundamentally the wrong question. Without the active participation of service users, organisations would struggle to deliver adequate services effectively. It is the organisations and service users who together ‘co-produce’ effective outcomes (Miller and Stirling, 2004).
2.1 What is it?
The importance of co-production has been recognised as a fundamental building block across all areas of public service. For example, the Cabinet Office (2008) defines co-production as
..a partnership between citizens and public to achieve a valued outcome
· Co-production empowers citizens to contribute their own resources (time, will power expertise and effort) and have greater control over public resources to achieve a valued outcome
· Government should foster co-production in public services because, it is: popular, effective, value for money and a massive opportunity to create public value
A recent SCIE research briefing (2009) suggests:
At its most effective, co-production can involve the transformation of services. The transformative level of co-production requires a relocation of power and control, through the development of new user-led mechanisms of planning, delivery, management and governance. It involves new structures of delivery to entrench co-production, rather than simply ad hoc opportunities for collaboration. It can be ‘a form of citizenship in practice’
Coproduction operates at two levels of action (Boviard, 2007): the direct improvement of an individual’s life; and the involvement of people in the planning and reshaping of services so that they enable effective coproduction. Both are important and inter related. However whilst the involvement of people in planning and reshaping services has received some attention (and is being pursued further within the TASC delivery support programme), co production at the level of directly influencing the lives of individual people is relatively unexplored. It is therefore this level of action on which the current DH social capital project is now focused.
Conclusion
The project should focus on coproduction as it applies to directly influencing the lives of people who use social care and the ways in which control over public resources can be devolved to local communities through new user-led mechanisms of planning, delivery and production.
2.2 How it works
Whenever an individual uses a service a coproduction relationship exists. Figure 2 outlines the relationships involved. The range of organisations whose services and facilities individuals use is very broad. In the past the major focus of public services has been on the delivery of publically funded universal and targeted services. These can be provided by the public service itself or by private and voluntary sector organisations that are in part of whole funded or procured by, the public sector. In social care this in turn meant that public services were mostly concerned with supporting those people who were eligible to receive state funding to pay for all or some of their social care services. PPF widens this view to also encompass enabling people who use social care and their carers who pay for their services out of their own resources i.e., ‘self funders’ and to wider preventative approaches. Hence there is a much concern to make sure that coproduction is effective when an individual directly procures their own services as when the state provides support to do so.
Alongside the use of social care and privately purchased or state funded targeted and universal services is the use that everyone makes of commercial services. These include: food and clothing stores; post offices and financial services; entertainment, culture, sport and leisure facilities; and the private sector as a source of employment opportunities. Like other services, their availability, accessibility, prices and pay rates greatly influence the opportunities available to people who use or may potentially use social care. Whilst, in the past, the role of these organisations has been recognised, with the exception of ensuring physical accessibility and employment initiatives, ensuring their services are tailored to the needs of people who use social care and their carers has not been a priority for commissioners of social care services. PPF now requires a focus on reshaping all services that are relevant to the lives of people who use social care.
Conclusion
The focus on coproduction should take into account the role played by all of the organisations services and facilities on which people draw to live their lives
Coproduction has always existed but mostly has not been an explicit focus for either service design or delivery. Whether or not the coproduction element is made explicit there is embedded in the design and practice of any service a set of expectations about the tasks, knowledge, skills, abilities and resources that people who use the service and their supporters should possess and be able to exercise to make use of the service. This is sometimes referred to as the ‘coproduction contract’ (Cummins and Miller, 2007).
Table 1: The implied coproduction contract for waste management
SERVICE / Home collection / Bulky refuse dump / Home compostingUser tasks / Separate waste into approved containers
Put containers out for collection at right time / Transport rubbish to appropriate place during opening times
Place rubbish in the right containers / Separate and compost waste
Ensure use of compost
Organisational tasks / Provide rubbish collection schedule and information on separation requirements and containers
Provide containers
Ensuring collection, processing and use / Information on location, opening times and usage
Rubbish separation containers
Direction and help at the dump
Ensure processing and use / Information on and encouraging composting
Subsidised compost bins
Table 2: The service user skills, knowledge and resources and access to social capital required for effective waste management
SERVICE / Home Collection / Bulky Refuse Dump / Home CompostingUser skills, knowledge and abilities / Know collection days and what to separate
Ability to lift / wheel bins / Know location and opening times of dump
Ability to drive and lift bulky items
Knowledge of collection services (e.g. voluntary groups who reuse / redistribute items) / Why and how to make compost
Ability to handle refuse and compost
User resources / Space to store separate bins / Own transport / A garden or allotment
A compost bin
Space for the compost bin
Access to social capital / Prompting about collection day
Someone to lift / wheel bin / Someone to lift and transport
Network of people who might be able to make use of unwanted items / Someone to help with composting
Someone to use compost if not needed yourself
Tables 1 and 2 provide an example of an implicit coproduction contract drawn from outside of adult social care. Focusing on the ‘home collection’ column it can be seen that many of the people who use social care would have both the skills, knowledge, abilities and or the social capital support to carry out the tasks required of the user to make use of the home collection service. However a significant number of people would not. It is for these people that the featured coproduction contract would need to be modified.
In adult social care the personalisation agenda takes this service redesign a stage further by enabling the people to either adapt existing services or design a new service or set of supports around themselves. Adaptations to an existing home care service might include: choosing your own carer; deciding which care tasks should be undertaken; and vary them according to your needs and schedule. These in turn will require changes in both the service and the way in which the coproduction contract is negotiated and maintained. Personalisation also enables people to focus on outcomes and therefore find completely different supports to achieve the same end. Hence instead of attending a day care centre as a way of meeting and being with other people a budget holder may pay for a season ticket to enable another person to accompany them to a football match. In coproduction terms this requires the person or their carer to have the skills and knowledge and access to social capital to set upon and maintain such an arrangement. It requires a complementary set of skills and resources on behalf of the person who will accompany the budget holder. It also has implications for the range of services and public sector resources that may need reshaping. These will include health, where personal budgets are being trailed, but also go much further, covering all services that impact on people’s lives.